Elderly Services Care Manager

Overview

Are you a compassionate professional who thrives on helping seniors stay safe, healthy, and independent? Then we’re looking for YOU to join our Elderly Services Program team at Community First Solutions! We are seeking a Care Manager to support older adults in Butler County by assessing needs, coordinating services, and ensuring quality care through the Elderly Services Program (ESP).

Responsibilities

• Maintain Client Caseload: Assess client referrals for program eligibility according to program policy and procedures; enroll eligible individuals
• Develop individualized service plans in collaboration with client and/or caregiver that includes community resources as well as ESP services
• Provide information, referrals, and/or resources as needed
• Inform clients of rights and responsibilities
• Monitor service plan costs to ensure we adhere to cost caps, per procedure
• Secure and monitor services to ensure quality of care to support the health and safety of the participants
• Maintain the client contact schedule of required interventions (phone or home visits) to assess and verify the service plan; identify any problems in service delivery and assess for any changes in client status, conditions or needs; provide support and assistance as needed and assure ongoing eligibility
• Complete documentation as required per procedure
• Maintain ongoing contact and open communication with caregivers, family members, friends and other sources of informal support as appropriate
• Work with clients, service providers and others involved in the client’s plan of care in mutual problem solving and coordination of care as needed
• Complete review of income and medical expenses to determine client co-payment amount if applicable. Monitor client’s co-payment status.
• Insurance, Medicare, Medicaid, Advantage plans, referrals to benefit specialist, payor of last resort, pursues other funding sources
• Assist client/caregiver with discharge planning upon disenrollment from ESP and/or from hospital/nursing home as appropriate
• Follow policy and procedure for processing client appeals and participate in appeal proceedings as required; disenroll clients who no longer meet eligibility requirements in accordance with policy and procedures
• Cooperate with care management team to assure adequate and appropriate care management coverage of all agency clients
• Maintain accurate and confidential computer record of client activity using care management software
• Adhere to confidentiality policy and HIPAA protocol as related to all client information/interactions
• Follow-up on reported incidents and health and safety issues. Complete incident reports and/or complaint form as necessary
• Participate in the PQI process as directed by supervisor or manager
• Promote a positive community image at all times
• Attend required program and agency trainings and meetings
• Participate in case conferences
• Attend professional meetings, workshops, seminars as appropriate

Qualifications

• Education and Licenses or other required certifications: Bachelor’s prepared degree in social work, gerontology or related field. Appropriate experience may suffice; approval required by program administrator.
• Must have an acceptable criminal records check.
• Must have valid driver’s license, insurance, reliable transportation and ability to complete home visits.
• Experience: Prefer at least one-year experience in geriatrics, case management, long-term care, home health or medical social work. Experience as a social worker or nurse is very helpful.